African-​​American vet­erans of the armed forces often struggle to get the health care they need, says a new report from North­eastern University’s Insti­tute on Urban Health Research (IUHR). The report, titled “Health Care Expe­ri­ences and Health Status of African-​​American Vet­erans” was par­tially funded by the Boston Public Health Com­mis­sion (BHPC) and the IUHR and was pre­pared in response to a request from the Tri Ad Vet­erans League, Inc., a Boston-​​based grass­roots group of African-​​American veterans.

Among the find­ings, North­eastern researchers reported that 78% of the respon­dents recalled having an expe­ri­ence of dis­crim­i­na­tion where they received health care ser­vices. Although on average, study par­tic­i­pants were mod­er­ately sat­is­fied with their health care, they indi­cated lack of con­fi­dence in the diag­nosis given to them by their doc­tors. They also expressed dis­sat­is­fac­tion with access to med­ical spe­cial­ists; the time their doc­tors spent with them; and get­ting med­ical care in a timely manner.

“Our study uncov­ered sig­nif­i­cant rela­tion­ships between per­ceived dis­crim­i­na­tion from health care providers and the sat­is­fac­tion with care in gen­eral,” says Nathaniel M. Rickles, Pharm.D., Ph.D., BCPP, assis­tant pro­fessor of phar­macy at North­eastern and lead author of the report. “We also found that there is a strong con­nec­tion between per­ceived dis­crim­i­na­tion and the level of phys­ical func­tioning of our respon­dents, which may be due to a delay in get­ting the ser­vices they need.”

Addi­tional find­ings include:

About two-thirds of the sample did not use VA as their sole provider, although only about 10% indicated a lack of willingness to use the VA in the future. The authors note that this indicates that the decision not to use VA services may have less to do with dissatisfaction with the VA system and more with their access to other sources of health care.

Many respondents expressed concern about their health care providers not asking them about their spiritual needs. The authors recommend future research to explore ways for VA providers to integrate chaplain services with medical care so African-American patients feel their spiritual needs are being met holistically by the medical team.

The report con­cludes that fur­ther research needs to be done to assess dis­crim­i­na­tion in health care of vet­erans. Rec­om­men­da­tions of Joseph D. Warren, Ph.D. of North­eastern University’s Office of Public Affairs and one of the authors of the report, include:

Health care systems serving veterans, especially the VA, should solicit the assistance of veteran’s advocacy groups, like the Tri Ad Veterans, to monitor and assist the VA to address identifiable disparities with access, patient satisfaction and quality of care.

A comprehensive review and ongoing performance-based monitoring of policies and provider behavior is needed, as well as further education of administrators and service providers about health disparities, unconscious clinician bias and cultural competency.

Policy changes and provider-level interventions are needed to reduce discrimination in health care.

“The effec­tive­ness of our mis­sion largely depends upon aca­d­emic insti­tu­tions, like North­eastern Uni­ver­sity, pro­viding the intel­lec­tual and sci­en­tific back­ground to our work,” says Hay­wood Fen­nell, founder of the Tri Ad Vet­erans League, Inc. “We are com­mitted to pro­viding the lead­er­ship to mobi­lize the nec­es­sary resources to imple­ment the rec­om­men­da­tions for future study.”

For more infor­ma­tion on the pilot study and for a copy of the report, please con­tact Renata Nyul at 617–373-7424 or at r.​nyul@​neu.​edu.

About North­eastern

Founded in 1898, North­eastern Uni­ver­sity is a pri­vate research uni­ver­sity located in the heart of Boston. North­eastern is a leader in inter­dis­ci­pli­nary research, urban engage­ment, and the inte­gra­tion of class­room learning with real-​​world expe­ri­ence. The university’s dis­tinc­tive coop­er­a­tive edu­ca­tion pro­gram, where stu­dents alter­nate semes­ters of full-​​time study with semes­ters of paid work in fields rel­e­vant to their pro­fes­sional inter­ests and major, is one of the largest and most inno­v­a­tive in the world. The Uni­ver­sity offers a com­pre­hen­sive range of under­grad­uate and grad­uate pro­grams leading to degrees through the doc­torate in six under­grad­uate col­leges, eight grad­uate schools, and two part-​​time divi­sions. For more infor­ma­tion, please visit www​.north​eastern​.edu.

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